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General NPI Number Information
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NPI Number | 1649065764
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Entity Type | Organization
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Legal Business Name | PRESTIGE HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 6100 GLADES RD STE 311
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City | BOCA RATON
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State | FL
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Zip | 33434-4325
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Country | US
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Telephone | 954-543-3541
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Fax |
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Provider Business Mailing Address
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Address Line | 9863 NW 28TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5041
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Country | US
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Telephone | 954-543-3541
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REGINALD EXILUS
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Credential |
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Telephone | 954-543-3541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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